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Behavior Management Training for the Treatment of Reactive Attachment Disorder

NCJ Number
Child Maltreatment Volume: 13 Issue: 3 Dated: August 2008 Pages: 289-297
Julia D. Buckner; Cristina Lopez; Stephanie Dunkel; Thomas E. Joiner Jr.
Date Published
August 2008
9 pages
This study discusses Reactive Attachment Disorder (RAD) a childhood disorder characterized by extremely inappropriate social relating across a variety of interactions that must be presented by the age of 5, and possible treatments for this disorder.
Findings show that children diagnosed with RAD appear to demonstrate more behavioral problems and psychosocial problems than children without RAD. Observed disturbances in social interactions are attributed to pathogenic care, defined as the failure to meet the basic emotional and/or physical needs of the child and/or and absence of a stable caregiver to which the child could form an attachment. RAD is characterized by two subtypes: inhibited and disinhibited according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association 1994). The inhibited children tend to be emotionally withdrawn and unlikely to seek comfort or attention, even from familiar adults; whereby the disinhibited children demand attention or affection from any adult including strangers. Despite the behavioral and emotional problems associated with RAD, epidemiological data for RAD prevalence rates are lacking. The majority of work investigating rates of RAD has examined whether children in foster care are at particular risk for RAD symptomatology. Existing treatments for RAD tend to be attachment-based therapies. Little research has been done on whether holding therapies are effective in the treatment of RAD. However, many mental health and professionals have cautioned this form of therapy because of physical injury and even death in children undergoing holding therapies (Chaffin et al., 2006). Safer and effective programs for treatment of disorders with similar symptoms are suggested. This case study outlines the use of behavior management training in the treatment of a 7-year-old girl with RAD. Figure, references